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The initial reactions of cholesterol synthesis, to the formation of isopentenyl pyrophosphate, are commonly referred to as the mevalonate pathway

Reduced levels of methylcobalamin can also prompt subacute spinal cord degeneration and megaloblastic iron deficiency.[4] A methyl group provided by methylcobalamin forms a bond with carbon monoxide to generate Acetyl-CoA

The American Academy of Dermatology 2021 guidelines on isotretinoin monitoring state: "Clinicians should ask patients at every visit about over-the-counter supplements, vitamins, and herbal products, as these are frequently overlooked sources of hepatotoxic exposure" [12]

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